FINGER is a 2-year multi-center randomized controlled trial (intervention study) carried out in Finland (Coordinated by the National Institute of Health and Welfare, Helsinki), in collaboration with Karolinska Institutet (Sweden), testing the effect of a multi-domain intervention in delaying cognitive impairment and disability in elderly at risk.

Participants

FINGER enrolled 1.260 participants aged 60-77 years recruited from previous population-based survey cohorts. Inclusion criteria were: CAIDE Dementia Risk Score >6 points, indicating the presence of modifiable risk factors; and cognitive performance at the mean level or slightly lower than expected for age. Participants were randomized (1:1) into either the multidomain intervention group or the control group. The intervention included nutritional guidance, physical exercise, cognitive training and social activities, and management of vascular risk factors. The control group received regular health advice.

Primary outcome

Primary outcome after 2 years is cognitive performance measured by a comprehensive neuropsychological test battery (NTB) composite Z score. An extended follow-up (7 years) with an ongoing sustenance intervention to evaluate longer-term effects on dementia/AD incidence, and secondary and exploratory outcomes including blood-based biomarkers and neuroimaging with MRI and PET. The 2-year intervention was finalized in February 2014. Here we report the main intention-to-treat (ITT) results on cognition after 2 years of intervention. Linear mixed-model statistical analyses were used. After 2 years, the NTB scores in the intervention group were 25% higher than in the control group. For some cognitive domains, the impact of the intervention was even larger. This is the first large RCT showing that it is possible to prevent cognitive decline using a multidomain intervention among older at-risk individuals. These results highlight the value of the feasible and novel multidomain approach that is effective for several cognitive domains.

RECENT PUBLICATIONS

About

The World Wide FINGERS (WWFINGERS) is an interdisciplinary network to share experiences, harmonise data, and plan joint international initiatives for the prevention of cognitive impairment or dementia.

Approach

Prevention of cognitive impairment requires integrated approaches targeting risk factors shared by chronic disorders common in older age, the definition of accessible and sustainable strategies for populations with different geographical, economic and cultural settings.